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2.
Niger J Clin Pract ; 23(11): 1583-1589, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33221786

RESUMO

Background: Congenial educational environment (EE) is paramount to effective impartation of knowledge as required in residency training. In this study EE for residency training is evaluated using Postgraduate Hospital Educational Environment Measure (PHEEM). Objectives: To assess the postgraduate educational environment at the University of Nigeria Teaching Hospital (UNTH), South-East Nigeria, using PHEEM and to determine if there are significant differences in PHEEM scores amongst various sub-groups of resident doctors. Methods: A cross-sectional study, employing a census survey, involving the administration of validated PHEEM questionnaires to residents in the Departments of Internal Medicine, Obstetrics/Gynaecology, Pediatrics and Surgery in the year 2018. Data entry and analysis were done using SPSS. ANOVA assessed significance of total scores and sub-scale scores. Cronbach's alpha was calculated. Results: A total of 114 Males and 46 females; 93 registrars and 67 senior registrars responded giving 71% response rate. Overall PHEEM score was 85.82; Role autonomy (29.27), Perception of teaching (34.80), Perception of social support (21.55). Males scored more than females in total PHEEM score (p = 0.000, F = 148.235), perception of teaching (P = 0.000, F = 420), and perception of social support (p = 0.000, F = 162.95), but not in role autonomy (p = 0.748, F = 0.104). Registrars scored more than senior registrars in total PHEEM (p = 0.000, F = 67.159), role autonomy (p = 0.000, F = 25.123), Perception of teaching (p = 0.000, F = 18.042) but not in perception of social support (p = 0.31, F = 1.045). There were significant differences in total and subscale scores amongst the specialties. Cronbach's alpha was 0.915. Conclusions: Postgraduate educational environment in UNTH has more positives than negatives but with room for improvement. There are significant differences in PHEEM scores among various groups of resident doctors.


Assuntos
Educação de Pós-Graduação em Medicina/normas , Avaliação Educacional/normas , Cirurgia Geral/educação , Ginecologia/educação , Medicina Interna/educação , Internato e Residência/normas , Obstetrícia/educação , Ensino/normas , Adulto , Estudos Transversais , Educação de Pós-Graduação em Medicina/métodos , Meio Ambiente , Feminino , Hospitais de Ensino , Humanos , Masculino , Pessoa de Meia-Idade , Nigéria , Percepção , Médicos/psicologia , Médicos/estatística & dados numéricos , Apoio Social , Inquéritos e Questionários
4.
Medicine (Baltimore) ; 99(43): e22562, 2020 Oct 23.
Artigo em Inglês | MEDLINE | ID: mdl-33120744

RESUMO

Simulation and Objective Structured Clinical Examination assessment of learners can teach clinical skills proficiency in a safe environment without risk to patients. Interprofessional simulation-based education (IPSE) contributes to a transformation in students' understanding of teamwork and professional roles. Long term outcomes for stimulation and IPSE sessions, are less well studied. We hypothesized that a progressive interprofessional education simulation program incorporating both faculty and interprofessional student collaboration would improve medical students' knowledge retention, comfort with procedural skills, positive teamwork and respectful interaction between students.An Obstetrics and Gynecology IPSE for medical and nursing students (NS) was developed in collaboration between a school of medicine and a school of nursing from 2014 to 2017. By 2017, content includedFrom 2014 to 2016, medical students completed attitude, knowledge, and perception surveys both pre and immediately post simulation, at 4 months, and 8 months. In 2017; all students completed self-assessments and received faculty-assessments.The program trained 443 medical and 136 NS. Medical students' knowledge, comfort, and interest increased significantly post simulation. Outcome scores decreased but were still significantly improved at 4 months but nearly dissipated by 8 months. There were no significant differences between medical and NS self-assessment or faculty-assessment scores regarding IUD insertion, cervical examination, or contraception quiz scores. Medical students' birth simulation self-assessment versus faculty-assessment scores were 8.6 vs 8.9, P < .001.Simulation improved students' short-term medical knowledge, comfort, and perception with some long-term persistence at 4-8 months. Medical and NS learned obstetrics and gynecology skills in a collaborative environment and in role-specific situations. Medical students had the opportunity to learn from NS. Positive teamwork and respectful interaction occurred between the students.


Assuntos
Ginecologia/educação , Obstetrícia/educação , Treinamento por Simulação , Estudantes de Medicina , Estudantes de Enfermagem , Atitude do Pessoal de Saúde , Competência Clínica , Estudos de Coortes , Comportamento Cooperativo , Currículo , Educação de Graduação em Medicina , Educação em Enfermagem , Humanos , Relações Interprofissionais
5.
Obstet Gynecol ; 136(5): 987-994, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-33030868

RESUMO

OBJECTIVE: To assess whether a pediatric and adolescent gynecology electronic learning (eLearning) module improves knowledge and clinical performance among obstetrics and gynecology residents. METHODS: We conducted a multi-institutional, single-blinded, randomized controlled trial across four university programs; three had pediatric and adolescent gynecology rotations, and two had pediatric and adolescent gynecology fellowship-trained faculty. Applying permutated block randomization, residents were randomized to no intervention or completion of a validated eLearning module on prepubertal bleeding. All residents subsequently completed a pediatric and adolescent gynecology-related knowledge assessment that queried understanding of prepubertal bleeding and an objective structured clinical examination that assessed history collection, performance of a prepubertal genital examination, vaginal culture, and vaginoscopy for a pediatric patient. Objective structured clinical examinations were videotaped and reviewed by two faculty, blinded to randomization group; interrater reliability score was 97%. We calculated descriptive frequencies and compared randomization groups using χ analyses and Fisher exact tests for categorical variables, and median tests for continuous variables; a value of P<.05 was considered significant. RESULTS: From July 2018 to June 2019, we invited 115 residents to participate; 97 (83%) completed both objective structured clinical examination and follow-up knowledge assessments. Most were female (91%) and the majority reported limited pediatric and adolescent gynecology didactic or clinical experience, with 36% reporting prior didactics on prepubertal vaginal bleeding and 33% reporting prior exposure to the prepubertal genital examination. Forty-five participants (46%) were randomized to the module and groups were similar across training levels. Residents assigned to the module scored significantly higher on the knowledge assessment (4/5 vs 2/5, P<.001) and objective structured clinical examination (13/16 vs 7/16, P<.001) and were more likely to avoid a speculum in the examination of a pediatric patient (95.6% vs 57.7%, P<.001). CONCLUSION: Our pediatric and adolescent gynecology eLearning module resulted in improved short-term resident knowledge and simulated clinical skills among obstetrics and gynecology residents. Applying this learning technique in other programs may help address deficiencies in pediatric and adolescent gynecology education and training.


Assuntos
Competência Clínica/estatística & dados numéricos , Ginecologia/educação , Internato e Residência/estatística & dados numéricos , Pediatria/educação , Treinamento por Simulação/métodos , Adolescente , Adulto , Criança , Currículo , Avaliação Educacional , Bolsas de Estudo/métodos , Bolsas de Estudo/estatística & dados numéricos , Feminino , Ginecologia/métodos , Humanos , Internato e Residência/métodos , Pediatria/métodos , Reprodutibilidade dos Testes , Método Simples-Cego
6.
Obstet Gynecol ; 136(5): 942-949, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-33030877

RESUMO

OBJECTIVE: To use the Messick validity framework for a simulation-based assessment of vaginal hysterectomy skills. METHODS: Video recordings of physicians at different levels of training and experience performing vaginal hysterectomy on a high-fidelity vaginal surgery model were objectively assessed using a modified 10-item Vaginal Surgical Skills Index, a one-item global scale of overall performance, and a pass-fail criterion. Participants included obstetrics and gynecology trainees and faculty from five institutions. Video recordings were independently assessed by expert surgeons blinded to the identities of the study participants. RESULTS: Fifty surgeons (11 faculty, 39 trainees) were assessed. Experience level correlated strongly with both the modified Vaginal Surgical Skills Index and global scale score, with more experienced participants receiving higher scores (Pearson r=0.81, P<.001; Pearson r=0.74, P<.001). Likewise, surgical experience was also moderately correlated with the modified Vaginal Surgical Skills Index and global scale score (Pearson r=0.55, P<.001; Pearson r=0.58, P<.001). The internal consistency of the modified Vaginal Surgical Skills Index was excellent (Cronbach's alpha=0.97). Interrater reliability of the modified Vaginal Surgical Skills Index and global scale score, as measured by the intraclass correlation coefficient, was moderate to good (0.49-0.95; 0.50-0.87). Using the receiver operating characteristic curve and the pass-fail criterion, a modified Vaginal Surgical Skills Index cutoff score of 27 was found to most accurately (area under the curve 0.951, 95% CI 0.917-0.983) differentiate competent from noncompetent surgeons. CONCLUSION: We demonstrated validity evidence for using a high-fidelity vaginal surgery model with the modified Vaginal Surgical Skills Index or global scale score to assess vaginal hysterectomy skills.


Assuntos
Competência Clínica/estatística & dados numéricos , Avaliação Educacional/normas , Histerectomia Vaginal/educação , Treinamento por Simulação , Cirurgiões/estatística & dados numéricos , Adulto , Feminino , Ginecologia/educação , Humanos , Masculino , Obstetrícia/educação , Reprodutibilidade dos Testes , Cirurgiões/educação
7.
Obstet Gynecol ; 136(5): 981-986, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-33030879

RESUMO

Shortly after its inception, the Society for Academic Specialists in General Obstetrics and Gynecology recognized that no data described the composition and faculty activities of "academic generalist divisions." Consequently, in 2018, the Society for Academic Specialists in General Obstetrics and Gynecology appointed a presidential task force and conducted the current surveys of chairs and division directors and key informant interviews to understand the composition and faculty activities in divisions of academic specialists in departments of obstetrics and gynecology and propose criteria for excellence in each mission area to guide development of divisions. In 2014, with Society for Academic Specialists in General Obstetrics and Gynecology's guidance, these divisions were referred to as academic specialists divisions and the faculty within as academic specialists to emphasize that they provide specialized women's health care in academic settings. The divisions comprised approximately 30% of departments' full-time faculty (median 12). In 27% of the departments, these divisions contributed more than half of departmental revenue, and 49% contributed 26-50%. Nearly 90% of divisions provided a sizeable proportion of the department's total teaching efforts. Compensation relied more on clinical productivity than on seniority, quality, academic contributions, or academic rank. Subsequently, five performance domains were identified to help divisions define divisional excellence: clinical, education, research, service & advocacy, and academic environment. Furthermore, excellent divisions were characterized as those with outstanding clinicians and educators who emphasize scholarly productivity. Although academic specialists contribute significantly to their departments' financial, clinical, and educational productivity, many have limited opportunities for scholarly activity. Achieving divisional excellence likely will depend on the ability to recruit and retain faculty with career expectations that align with the division's prioritized performance domains.


Assuntos
Docentes de Medicina/tendências , Ginecologia/tendências , Obstetrícia/tendências , Especialização/tendências , Centros Médicos Acadêmicos , Comitês Consultivos , Docentes de Medicina/organização & administração , Feminino , Ginecologia/educação , Ginecologia/organização & administração , Humanos , Obstetrícia/educação , Obstetrícia/organização & administração , Gravidez , Sociedades Médicas
9.
Aust N Z J Obstet Gynaecol ; 60(6): 983-986, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-32929718

RESUMO

The COVID-19 pandemic has significantly disrupted training in obstetrics and gynaecology. Past pandemics have been shown to result in significant psychological morbidity. As specialty trainees continue frontline work, they will face unprecedented work environments and may face delays in progression due to postponed examinations, case log shortfalls and inadequate clinical rotations. This contributes to burnout, anxiety and depression. We share technology-based suggestions as well as institutional, departmental and self-care tips on how to maintain trainees' mental well-being during the fight against COVID-19.


Assuntos
Esgotamento Profissional/psicologia , Ginecologia/educação , Pessoal de Saúde/psicologia , Obstetrícia/educação , Atitude do Pessoal de Saúde , Humanos , Saúde Mental , Inquéritos e Questionários , Comunicação por Videoconferência
10.
Semin Perinatol ; 44(6): 151297, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32958291

RESUMO

The COVID-19 pandemic created unique issues for house staff physicians. Gaps in surgical experience due to canceled cases, a focus on obstetrics over gynecology during the spring months when many senior residents and fellows are completing their case requirements and the stress of working with patients infected with a highly communicable disease all contributed to an unprecedented challenge facing residency and fellowship programs. Our objective is to describe how the Obstetrics and Gynecology residency and fellowship programs at Columbia University Irving Medical Center adapted to their changing landscape, redeployed their residents and fellows while assuring ongoing trainee education, wellness and scholarship during the peak of the pandemic.


Assuntos
/epidemiologia , Bolsas de Estudo , Ginecologia/educação , Internato e Residência , Obstetrícia/educação , Centros Médicos Acadêmicos , Currículo , Feminino , Humanos , Saúde Mental , Cidade de Nova Iorque/epidemiologia , Pandemias , Admissão e Escalonamento de Pessoal , Gravidez , Complicações Infecciosas na Gravidez/virologia , Estudantes de Medicina/psicologia
11.
Surgery ; 168(5): 898-903, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32868108

RESUMO

BACKGROUND: This study utilized the Team Strategies and Tools to Enhance Performance and Patient Safety and the Nontechnical Skills for Surgeons grading systems to evaluate the nontechnical skills of general surgery and obstetrician/gynecologist residents to see if these grading systems were concordant. These simulations were also intended to teach about crisis resources available at our institution. METHODS: Nineteen teams were created consisting of either one general surgery resident or 2 Obstetrician/Gynecologist residents plus 2 Anesthesia residents and 2 to 4 nurses. Each team was given a short briefing on Team Strategies and Tools to Enhance Performance and Patient Safety, then performed 2 simulated operating room crises. All exercises were graded by 2 independent observers with experience in the operating room and in using the Team Strategies and Tools to Enhance Performance and Patient Safety and Nontechnical Skills for Surgeons grading systems. RESULTS: Averaged general surgery Team Strategies and Tools To Enhance Performance and Patient Safety score increased between scenarios (14.3-17; P ≤ .01), as did obstetrician/gynecologist Team Strategies and Tools to Enhance Performance and Patient Safety score (14.9-19.2; P ≤ .01). Averaged general surgery Nontechnical Skills for Surgeons score increased between scenarios (10.3-12.2; P ≤ .02), as did obstetrician/gynecologist Nontechnical Skills for Surgeons score (10.2-14.3; P ≤ .01). Surgery Team Strategies and Tools to Enhance Performance and Patient Safety scores demonstrated a strong correlation of movement with Nontechnical Skills for Surgeons scores (r = 0.83), as did obstetrician/gynecologist (r = 0.91). On average both general surgery (11%-100%; P ≤ .01) and obstetrician/gynecologist (50%-90%; P ≤ .01) saw a statistically significant increase in their awareness of the crisis checklist. CONCLUSION: Team Strategies and Tools to Enhance and Patient Safety scores and Nontechnical Skills for Surgeons are effective and concordant tools for gauging general surgery and obstetrician/gynecologist resident nontechnical skills. In situ simulations are an effective way to teach general surgery and obstetrician/gynecologist residents about available crisis resources.


Assuntos
Competência Clínica , Cirurgia Geral/educação , Ginecologia/educação , Internato e Residência , Obstetrícia/educação , Salas Cirúrgicas , Treinamento por Simulação , Humanos , Equipe de Assistência ao Paciente , Segurança do Paciente
12.
Eur J Obstet Gynecol Reprod Biol ; 253: 48-51, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32771888

RESUMO

OBJECTIVE: to evaluate the impact of the COVID-19 pandemic on the obstetrics and gynecology residency training program in Italy. STUDY DESIGN: This was a cross-sectional survey study aimed to assess the impact of the COVID-19 pandemic on the obstetrics and gynecology residency training program in Italy. An online survey with 45 questions was sent and completed anonymously by residents after accepting an informed consent. The invitation to the online survey was sent to all the Italian residents in obstetrics and gynecology. Those on maternity leave at the time of the study were excluded. Residents were asked about their routinely activity before the COVID-19 pandemic, and to report the reduction in their clinical practice. They were also asked about psychological impact of COVID-19 on their clinical practice. RESULTS: 933 Italian residents in obstetrics and gynecology, were invited for this survey study. Four-hundred and seventy-six (51 %) completed the survey and were included in the study. Three-hundred and eighty-seven (81.3 %) were female, and 89 (18.7 %) were male. Residents age ranged from 25 to 42. In 71,8 % (342/476) of the cases residents work in a COVID-19 reference Hospitals. One-hundred and eighty-four out of 76 residents (38.6 %) were tested on RT-PCR assay of nasal and pharyngeal swab specimens, and of them 12/184 (6.5 %) were positive to SARS-COV-2. Regarding the use of personal protective equipment (PPE), 267 (56.1 %) reported to receive adequate device, and 379 (79.6 %) felt to be well informed about prevention and management protocols. Three-hundred and thirty-one residents (69.5 %) reported to have managed COVID-19 positive patients. For 54,7 % of respondent residents, training activity in general decreased significantly during the COVID-19 epidemic. A one-third reduction was reported in 31,4 % of the cases, whereas a total suspension of the training in 9,9 % of the cases. In 89,3 % of cases the reduction was caused by the reorganization of work. Anxiety about the professional future was reported in 84 % of the residents, and 59 % of them had the perception that their training was irreversibly compromised. CONCLUSIONS: Among Italian residents in obstetrics and gynecology, COVID-19 pandemic was associated with a significant training impairment.


Assuntos
Competência Clínica/estatística & dados numéricos , Infecções por Coronavirus , Ginecologia/educação , Internato e Residência/estatística & dados numéricos , Obstetrícia/educação , Pandemias , Pneumonia Viral , Adulto , Betacoronavirus , Feminino , Humanos , Itália/epidemiologia , Masculino , Gravidez , Complicações Infecciosas na Gravidez/epidemiologia , Complicações Infecciosas na Gravidez/virologia
14.
Obstet Gynecol ; 136(2): 369-376, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32649501

RESUMO

OBJECTIVE: To assess self-reported readiness of U.S. obstetrics and gynecology residents to perform surgical procedures compared with the perceptions of their program directors. METHODS: The 2019 Council on Resident Education in Obstetrics and Gynecology Survey assessed resident self-confidence and perceived readiness to independently perform common surgical procedures. Concurrently, obstetrics and gynecology residency program directors were surveyed about the readiness of their graduating residents to independently perform the same procedures. RESULTS: The overall response rate was 99.3% for residents (5,473/5,514 examinees attempted to complete the survey) and 83% for program directors (241/292 returned surveys). There were no significant differences in graduating residents and program directors' assessments of graduating residents' surgical confidence in performing cesarean delivery (99.6% [95% CI 98.9-99.9] vs 100% [95% CI 98.2-100.0]), vacuum delivery (96.5% [95% CI 95.2-97.4] vs 98.6% [95% CI 95.9-99.7]), abdominal hysterectomy (95.1% [95% CI 93.6-96.2] vs 96.7% [95% CI 93.3-98.7]) or operative hysteroscopy (99.5% [95% CI 98.9-99.9] vs 100% [95% CI 98.2-100.0]). Ninety percent, 86%, and 69% of graduating residents felt that they could independently perform an abdominal hysterectomy, laparoscopic hysterectomy, and vaginal hysterectomy, respectively, in the event of an emergency. Ninety-seven percent (95% CI 93.3-98.7) of program directors reported their residents could perform a laparoscopic hysterectomy by graduation, as did 93% of graduating resident respondents (95% CI 90.8-94.0). Ninety percent (95% CI 85.3-93.8) of program directors felt their residents could perform vaginal hysterectomies by graduation, compared with 79% (95% CI 76.9-81.8) of fourth-year residents. CONCLUSION: Graduating obstetrics and gynecology residents and their program directors are confident in their abilities to perform the majority of core surgical procedures by graduation. By the second year, more than 90% of residents and their program directors were confident in their ability to perform cesarean deliveries and operative hysteroscopy. Sixty-nine percent and 86% of graduating residents felt comfortable performing vaginal and laparoscopic hysterectomies, respectively.


Assuntos
Competência Clínica , Educação de Pós-Graduação em Medicina , Procedimentos Cirúrgicos em Ginecologia/educação , Procedimentos Cirúrgicos Obstétricos/educação , Cesárea/educação , Feminino , Ginecologia/educação , Humanos , Histerectomia/educação , Histeroscopia , Internato e Residência , Masculino , Obstetrícia/educação , Autoimagem , Autorrelato , Inquéritos e Questionários , Estados Unidos
15.
Am J Obstet Gynecol ; 223(5): 715.e1-715.e7, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32697956

RESUMO

As an academic department, we sought to identify effective strategies to engage our faculty and staff in diversity, equity, and inclusion initiatives and programs to build an inclusive department that would address our needs and those of our community and partners. Over a 4-year period, our faculty and staff have participated in town hall meetings, focus group discussions, surveys, and community-building activities to foster stakeholder engagement that will build a leading academic department for the future. We noted that our faculty and staff were committed to building diversity, equity, and inclusion, and our mission and vision were reflective of this. However, communication and transparency may be improved to help support a more inclusive department for all. In the future, we hope to continue with the integration of diversity, equity, and inclusion into our department's business processes to achieve meaningful, sustained change and impact through continued focus on recruitment, selection, retention, development, and wellness of faculty and staff-in addition to the continued recruitment of faculty and staff from underrepresented minority groups. Our findings should serve as a call to action for other academic obstetrics and gynecology departments to improve the health and well-being of the individuals we serve.


Assuntos
Diversidade Cultural , Docentes de Medicina , Grupos Minoritários , Unidade Hospitalar de Ginecologia e Obstetrícia/organização & administração , Relações Médico-Paciente , Ginecologia/educação , Humanos , Obstetrícia/educação , Seleção de Pessoal , Reorganização de Recursos Humanos , Desenvolvimento de Pessoal , Participação dos Interessados , Visitas com Preceptor , Local de Trabalho
16.
J Perinat Med ; 48(9): 1013-1016, 2020 Nov 26.
Artigo em Inglês | MEDLINE | ID: mdl-32692706

RESUMO

COVID-19 pandemic is changing profoundly the obstetrics and gynecology (OB/GYN) academic clinical learning environment in many different ways. Rapid developments affecting our learners, patients, faculty and staff require unprecedented collaboration and quick, deeply consequential readjustments, almost on a daily basis. We summarized here our experiences, opportunities, challenges and lessons learned and outline how to move forward. The COVID-19 pandemic taught us there is a clear need for collaboration in implementing the most current evidence-based medicine, rapidly assess and improve the everchanging healthcare environment by problem solving and "how to" instead of "should we" approach. In addition, as a community with very limited resources we have to rely heavily on internal expertise, ingenuity and innovation. The key points to succeed are efficient and timely communication, transparency in decision making and reengagement. As time continues to pass, it is certain that more lessons will emerge.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Ginecologia/educação , Obstetrícia/educação , Pandemias , Pneumonia Viral/epidemiologia , Estágio Clínico , Currículo , Assistência à Saúde/tendências , Medicina Baseada em Evidências , Bolsas de Estudo , Feminino , Hawaii/epidemiologia , Humanos , Internato e Residência , Gravidez , Estudantes de Medicina
17.
Womens Health Issues ; 30(5): 353-358, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32669243

RESUMO

BACKGROUND: Abortion is a common medical procedure, integral to women's health, and a core educational topic for medical students. Medical schools often rely on brief clinical exposure to abortion during the obstetrics and gynecology clerkship to provide this learning. Abortion is also a highly politicized and stigmatized procedure. Given this potential conflict, we examine medical student reactions to their observation of abortion care. STUDY DESIGN: Medical students in their second and third years at an academic medical center who observed in a first trimester abortion clinic completed open-ended, written questionnaires. Questionnaires explored student reactions to participating in the abortion clinic. We used applied thematic analysis to code and qualitatively analyze 78 questionnaires. RESULTS: We identified the following five themes: (1) students found participating in abortion care deeply worthwhile, (2) some were challenged by their reactions, particularly when reactions conflicted with prior beliefs, (3) some demonstrated empathy for the patient, but (4) some expressed judgment of both the patient and the abortion provider, and (5) students reported a desire for curricular change around abortion education, requesting more time for reflection, and some felt that their abortion observation might better prepare them to serve future patients. CONCLUSIONS: Observing in an abortion clinic is a valued experience that allows students to challenge their existing beliefs and may build empathy. Educators should provide students with adequate time for preparation and reflection around this topic and address areas of misunderstanding that may perpetuate abortion stigma. These findings may inform medical student curriculum changes around abortion.


Assuntos
Aborto Induzido/psicologia , Estudantes de Medicina/psicologia , Aborto Induzido/educação , Adulto , Instituições de Assistência Ambulatorial , Currículo , Feminino , Ginecologia/educação , Humanos , Masculino , Obstetrícia/educação , Gravidez , Primeiro Trimestre da Gravidez , Inquéritos e Questionários , Estados Unidos
18.
Am J Obstet Gynecol ; 223(3): 383.e1-383.e7, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32561227

RESUMO

The coronavirus disease 2019 pandemic has significantly disrupted operations in academic departments of obstetrics and gynecology throughout the United States and will continue to affect them in the foreseeable future. It has also created an environment conducive to innovation and the accelerated implementation of new ideas. These departments will need to adapt their operations to accommodate coronavirus disease 2019 and to continue to meet their tripartite mission of clinical excellence, medical education, and women's health research. This "Call to Action" paper from the leaders of American Gynecological and Obstetrical Society and Council of University Chairs of Obstetrics and Gynecology provides a framework to help the leaders of departments of obstetrics and gynecology reimagine and reengineer their operations in light of the current coronavirus disease 2019 crisis and future pandemics.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Ginecologia , Obstetrícia , Pneumonia Viral/epidemiologia , Academias e Institutos , Educação Médica , Ginecologia/educação , Humanos , Obstetrícia/educação , Pandemias , Segurança do Paciente , Sociedades Médicas , Saúde da Mulher
19.
Am J Obstet Gynecol ; 223(5): 665-673, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32585225

RESUMO

Gender equity in medicine and surgery has recently received widespread attention. Unlike surgical specialties that remain predominantly male, the majority of obstetrician-gynecologists have been women for nearly a decade, and women have composed the majority of trainees since the 1990s. Despite a critical mass of women, biases related to gender persist in the field. Professional and behavioral expectations of men and women gynecologists remain different for patients and workplace colleagues. Gender discrimination and sexual harassment are still experienced at high rates by both trainees and obstetrician-gynecologists in practice. In addition, in other surgical fields, women gynecologic surgeons face a gender wage gap that is unexplained by differences in experience, hours worked, or subspecialty training. Academic advancement and the attainment of leadership positions remain a challenge for many women. Policies related to pregnancy and parenting may disproportionately affect the careers of women gynecologists. This article presents peer-reviewed evidence relevant to gender equity in the workplace and suggests proactive interventions to ensure diversity and inclusion for gynecologic surgeons.


Assuntos
Educação de Pós-Graduação em Medicina , Ginecologia , Médicas , Salários e Benefícios , Sexismo , Assédio Sexual , Identidade de Gênero , Ginecologia/educação , Humanos , Política Organizacional , Licença Parental , Profissionalismo
20.
Arch Gynecol Obstet ; 302(2): 431-438, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32488397

RESUMO

INTRODUCTION: Our study assesses the patients' opinion about gynecological examination performed by undergraduate students (UgSts). This assessment will be used in improving our undergraduate training program. A positive opinion would mean a lower chance of a patient refusing to be examined by a tutor or student, taking into account vaginal examination (VE). MATERIALS AND METHODS: We performed a prospective cross-sectional survey on 1194 patients, consisting of outpatient and inpatient at the departments of obstetrics and gynecology from November 2015 to May 2016. The questionnaire consisted of 46 questions. Besides demographic data, we assessed the mindset of patients regarding the involvement of undergraduate student (UgSt) in gynecological and obstetrical examinations. We used SPSS version 23 for the statistical analysis. For reporting the data, we followed the STROBE statement of reporting observational studies. RESULTS: The median age was 38 years having a median of one child. 34% presented due to obstetrical problems, 38% due to gynecological complaints, and 19% due to known gynecological malignancies. Generally, we retrieved a positive opinion of patients towards the involvement of students in gynecological and obstetrical examination under supervision in 2/3 of the cases. CONCLUSIONS: There is no reason to exclude medical UgSts from gynecological and obstetrical examinations after obtaining a written or oral consent.


Assuntos
Educação de Graduação em Medicina/normas , Ginecologia/educação , Obstetrícia/educação , Estudantes de Medicina/estatística & dados numéricos , Adulto , Estudos Transversais , Feminino , Humanos , Gravidez , Estudos Prospectivos
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